What to Know When Considering Medication for Anxiety and Depression

By Libby Pellegrini MMS, PA-C

March 22, 2021

Depression Meds

Anxiety and depression rates are on the rise, with more than 42% of American adults recently reporting a mental health struggle, according to the U.S. Census Bureau. If you or a loved one are facing a psychological challenge, you are not alone. The good news is that many resources are available to people suffering from mental health conditions, including prescription medication.

You may be considering a medication to help with your symptoms, but it can be daunting to take the first step. Follow this primer about the common types of medications and the other considerations that are at play when it comes to initiating a prescription medication for a mental health disorder.

How Do Anxiety and Depression Medications Work?

Most medications that are prescribed for anxiety or depression act on the neurotransmitters, or chemical messengers, that work within the brain. Here are the main categories of medications that are initially prescribed and how they work.

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are the most commonly prescribed antidepressant medications, and they are also commonly used to treat generalized anxiety disorder (GAD). SSRIs prevent neurons from reabsorbing the serotonin molecule, which increases the amount of serotonin that is available within the spaces between neurons. Common SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft).

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs help treat depression and anxiety in a way that is similar to SSRIs. They prevent the reabsorption of the neurotransmitter molecules serotonin and norepinephrine, therefore making them more plentiful and accessible. Common SNRIs include venlafaxine (Effexor), desvenlafaxine (Pristiq), and duloxetine (Cymbalta).

Atypical Antidepressants

Other types of medication, such as bupropion (Wellbutrin) and mirtazapine (Remeron), are also used for the initial treatment of depression. Bupropion prevents the reuptake of the neurotransmitters dopamine and norepinephrine, whereas mirtazapine works on specific receptors to promote the release of norepinephrine and serotonin.

Benzodiazepines

These medications are specifically used for the treatment of anxiety conditions. They work at the central nervous system’s gamma-aminobutyric acid (GABA) receptors, making the naturally circulating GABA neurotransmitter more powerful. This has the effect of calming a person down, and its effect can be almost immediate. However, because of this sense of immediate relief, benzodiazepines are used very carefully so that people do not become dependent on them. Common benzodiazepines include alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), and clonazepam (Klonopin).

Other Medications

Many other types of medications are used less commonly for the initial treatment of depression and anxiety. Regardless of the type of medication prescribed, it is important to keep in mind that the grand majority of medications that are prescribed for anxiety or depression take some time to exert their effects. Many clinicians advise their patients that they may not experience the full effect of a medication for several weeks. Additionally, all antidepressants increase the risk of suicidal thoughts or behavior in young adults, so it is crucial to monitor yourself or a loved one when a new medication is initiated.

Common Contraindications to Anxiety and Depression Medications

When it comes to medications used for anxiety and depression, some conditions or other medications are not compatible with specific treatment plans.

These conditions may include:

  • Alcohol abuse
  • Cardiac conditions
  • Eating disorders such as bulimia nervosa or anorexia nervosa
  • Recent use of other specific medications
  • Seizure disorders

Make sure to inform your medical provider of every component of your medical history when considering medication for anxiety or depression.

Medical Considerations

When choosing a medication for depression or anxiety, you will want to discuss your complete medical history with your clinician. Some medications may be complementary with other medical conditions that you may have (such as menopausal symptoms, insomnia, chronic pain, or nicotine addiction), so they may be the best choice for you. Others may have negative interactions with the other medications or supplements that you are already taking.

It is important to note that all antidepressants have comparable efficacies, but some work better than others for certain people. This means that you might have to try a few different types, or a few different doses, before you succeed in pinpointing the medication that works the best for you.

Lifestyle Considerations

When you are considering medication for anxiety or depression, make sure to discuss your lifestyle preferences with your provider. You may want to carefully review the side effect profile of each medication and discuss with your provider how sensitive you may be to certain side effects, such as weight gain or sexual dysfunction. You may also want to discuss with your provider whether you are pregnant, planning to become pregnant, or breastfeeding. Your engagement in behaviors such as routinely drinking alcohol or using marijuana will also be important for your provider to take into account.

Other Resources Available for Anxiety and Depression

Prescription medication is not the only resource available when it comes to treating anxiety and depression. You may also want to discuss other treatment strategies with your provider, such as alterations in your diet, sleep patterns, sun exposure, exercise regimen, or external stressors.

Additionally, pairing medication with psychotherapy as a treatment strategy may be very helpful. In fact, studies have shown that the combination of prescription medication with psychotherapy is more powerful for the treatment of depression than either treatment alone.

How to Learn More

If you are considering starting a medication for depression or anxiety, make sure to discuss your thoughts with your medical provider. Regardless of which medication you ultimately choose, use ScriptSave® WellRx to save up to 80% at the pharmacy.

Libby Pellegrini is a nationally certified physician assistant. She has worked in numerous healthcare settings, including the rural United States, an inner-city Level I trauma center, several suburban acute care centers, and a boutique, personalized medicine clinic in Southeast Asia. She graduated Magna Cum Laude from Northwestern University’s Medill School of Journalism.

References:

https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm

https://magazine.medlineplus.gov/article/commonly-prescribed-antidepressants-and-how-they-work

https://www.wellrx.com/prescriptions/celexa/

https://www.wellrx.com/prescriptions/lexapro/

https://www.wellrx.com/prescriptions/Prozac/

https://www.wellrx.com/fluvoxamine%20maleate%20er/coupon/

https://www.wellrx.com/prescriptions/paxil/

https://www.wellrx.com/prescriptions/zoloft/

https://www.wellrx.com/news/effexor-vs-wellbutrin-what-is-the-difference/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514842/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907331/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/

https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml

https://pubmed.ncbi.nlm.nih.gov/19818243/

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